1. Field of the Invention
The invention generally relates to orthopedic devices. More specifically, the present invention is a surgical tool or medical construct used with spinal rods for the purpose of spinal fixation and correction of spinal curvature.
2. Description of Related Art
Spinal rods are often used for spinal fixation, including for correction of scoliotic curves. Fixation using such rods often involves implantation of rods and attaching them to the spine by anchors in the form of hooks and/or screws. Usually, a pair of rods are placed on opposite sides of the portion of the spine to be fixed.
Various systems have been developed for cross linking spinal rods to prevent rod migration and to increase stiffness of the paired rod assembly.
Many assemblies used for interconnecting spinal rods, commonly referred to as transverse connector assemblies or rod to rod connectors, utilize a plate mechanism having openings therethrough for adjustably retaining hook systems that are bolted in place in the plate. Examples of such systems include U.S. Pat. No. 5,334,203 to Wagner and U.S. Pat. No. 5,522,816 to Dinello et al. U.S. Pat. No. 5,498,263 to Dinello et al., for instance, discloses a transverse connector system utilizing set screws to interconnect vertebrae coupling members while also using plate members as described above for interconnecting the coupling members. A square unit is formed having two sides defined by the plate members and two sides defined by the spaced rods.
U.S. Pat. No. 5,312,405 to Korotko et al. discloses a coupler used for interconnecting spinal rods wherein the coupler itself is a two piece unit. The neck portion of each unit is interconnected by a screw mechanism which clamps a male portion within a female portion of the system. The system also utilizes coupler inserts or yokes which engage a rod and are compressed about the rod when disposed within a seat portion of each coupler and compressed by an instrument which engages the bottom of the rod between the rod and the spine and the top of the coupler.
In further attempts to overcome these problems, various patents have disclosed devices wherein the set screw directly contacts the rod. Examples of such patents include U.S. Pat. No. 6,113,600 to Drummond et al., U.S. Pat. No. 5,624,442 to Mellinger et al., and U.S. Pat. No. 5,601,552 to Cotrel. In these patents, the force required to lock the set screw causes deformation of the rod at the point of contact of the set screw. This is more severe in cases where the set screw tip is conically shaped such as that found in FIG. 6 of the Drummond et al. patent. This causes deeper, more localized deformation and therefore stress inducing indentation that can lower rod fatigue life. Additionally, the depth of the notch, as well as the induced localized stress is subject to random values based on how tight the surgeon tightens the set screw at the time of surgery.
Numerous spinal rod systems have also been developed which provide transverse connectors for linking the adjacent spinal rods across the spinal midline to provide a rigid and stable construct. Most of these systems present one or more difficulties for spinal surgeons. Many of the devices are high profile, which increases soft tissue trauma and surgical complications. Furthermore, in many of these prior art systems, the attachment devices must be preloaded on the spinal rods, which can require significant pre-operative planning and which virtually eliminates the opportunity to add connectors in situ.
One transverse connector system is the TSRH™ CROSSLINK™ of Danek Medical, Inc. The TSRH™ CROSSLINK™ utilizes a three point shear clamp mechanism which restricts motion between the rods in all directions, and particularly resists axial forces between rods and torsional moments about the axis of the rods. A quadrilateral construct is formed by laterally connecting the rods across the sagittal plane with rigid plates. The lateral connection reduces the loss of correction that can occur over time.
Rigid transverse connections between spinal rods are beneficial because they restrict rod migration and increase construct stiffness. In many cases involving multi-level fusion of the spine, these features are highly beneficial while stabilizing the spine construct until fusion in accomplished while solid bone fusion is accomplished. In the post-operative period before fusion occurs, a significant amount of motion can occur between the rods, wires and hooks, which can, for example, allow a scoliotic correlation to decrease or the pelvis to de-rotate toward its previous, deformed position. By providing a rigid transverse connection between two spinal rods, the loss of correction can be reduced and a stiffer construct can be created which may enhance the promotion of a solid fusion. While other devices may provide a good construct, a need has remained for low profile devices where the surface area of contact with the rod is greatly increased and thus minimizes localized stress regardless of how tight the set screw is secured.
It is sometimes the case that the two side by side spinal rods that are to be interconnected by a rod to rod connector are not perfectly parallel to each other. This is a problem for many rod to rod connectors of the prior art which do not permit for any angle between the two spinal rods.
It is an object of the present invention to provide a rod to rod connector that engages a rod by a simple locking mechanism.
It is another object of the present invention to provide a rod to rod connector having few parts and requiring minimal manipulation to assemble and provide the interconnection.
It is a further object of the present invention to provide a rod to rod connector that requires only a simple screw driver or nut driver outside of the assembly for its interconnection between a pair of spinal rods.
It is yet another object of the present invention to develop a rod to rod connector having a surface area of contact with the rod that is greatly increased and thus minimizes localized stress regardless of how tight the set screw is set.
Even further, it is an object of the present invention to provide a rod to rod connector that permits for different angles between two side-by-side spinal rods.